erika nora
@erikanora
I investigate complex healthcare claims, billing discrepancies, and financial resolution.
United StatesWhat I'm looking for
I've spent more than 10 years investigating healthcare claims, reimbursement issues, billing discrepancies, and complex financial accounts. My work starts when information does not add up: I review documentation, reconstruct timelines, identify responsibility, and follow issues through resolution.
At UT Southwestern Medical Center, I manage financial review and billing activity across 150–300 clinical research accounts. I analyze charges, reimbursement, coverage analyses, study protocols, invoices, and compliance requirements to support accurate, audit-ready resolution.
Previously, I managed high-dollar self-pay, accounts receivable, and bad debt portfolios, investigated denied claims and workers’ compensation accounts, and coordinated with vendors, insurance carriers, legal teams, finance, and operational leadership. I've also developed SOPs, workflow standards, and training that strengthened documentation consistency and escalation handling.
I'm deliberately bringing my background in investigation, financial analysis, documentation review, compliance, and root-cause analysis into insurance, claims, risk, property, and insurance operations. I’m drawn to work where sound judgment and clear documentation help make sense of complicated situations.
Experience
Work history, roles, and key accomplishments
Manage financial review and billing activity across 150–300 clinical research accounts, analyzing charges, reimbursement, documentation, and financial responsibility. Perform account audits, invoice review, reconciliation, and compliance analysis, and investigate complex billing and multi-system discrepancies.
Lead Bad Debt Self-Pay Account Liaison
Nov 2019 - Jan 2024 (4 years 2 months)
Managed complex high-dollar self-pay, accounts receivable, and bad debt portfolios across hospital and physician billing systems. Investigated escalated account issues, performed audits and reconciliations, and developed SOPs and training for billing and CRM teams.
Billing Account Resolution Specialist II
Dec 2017 - Nov 2019 (1 year 11 months)
Investigated denied claims, reimbursement disputes, workers' compensation accounts, and insurance coverage issues. Reviewed insurance documentation and payer requirements, coordinated with carriers and internal teams, and documented investigation findings.
Managed revenue cycle work queues involving insurance eligibility audits, prior authorizations, appeals, and reimbursement review. Investigated data inconsistencies and coordinated with internal teams and insurance representatives to resolve account issues.
Coordinated insurance verification, eligibility review, prior authorization, and surgical admission workflows in a high-volume pediatric healthcare environment. Worked with insurance representatives and clinical teams to clarify coverage and obtain authorizations.
Education
Degrees, certifications, and relevant coursework
DeSoto High School
High School Diploma, General Studies
2005 - 2009
Completed upper secondary education at DeSoto High School in Texas from 2005 to 2009.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
Skills
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